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Abstract Details
Hepatitis C Seroprevalence Among Consecutive Labor and Delivery Admissions in Two New York City Hospitals
Open Forum Infect Dis. 2020 Oct 23;7(11):ofaa514. doi: 10.1093/ofid/ofaa514.eCollection 2020 Nov.
Tatyana Kushner12, Claire Park2, Dana Masand2, Brian Wagner3, Marie Grace4, Emma Rosenbluth12, Clara Rodriquez-Rivas12, Hernis de la Cruz5, Jessica Overbey5, Rhoda Sperling26
Author information
1Department of Medicine, Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
2Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
3Department of Obstetrics and Gynecology and Reproductive Science, Division of Maternal Fetal Medicine, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
4Department of Pathology and Laboratory Medicine, Icahn School of Medicine at Mount Sinai.
5Department of Population Health Science and Policy, Center for Biostatistics, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
6Department of Obstetrics, Gynecology and Reproductive Science and the Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Abstract
Background: Rates of hepatitis C virus (HCV) among women of childbearing age have increased as a result of the opioid epidemic, especially in the nonurban white population. Recently updated US Preventative Services Task Force and Centers for Disease Control and Prevention guidance have recommended universal HCV screening during pregnancy, but obstetrics societies have not yet endorsed this recommendation. We evaluated the seroprevalence of HCV among pregnant women in an inner-city population, compared rates with other sexually transmitted infections (STIs) screened for during pregnancy, and evaluated factors associated with HCV positivity.
Methods: We performed a prospective seroprevalence study of consecutive labor and delivery admissions (both antepartum complications and delivery admissions) by testing serum samples for HCV antibody over 9 months at 2 major hospital settings in New York City.
Results: Fifty-six of 7373 (0.75%; 95% confidence interval [CI], 0.57-0.98) patients screened positive for HCV, with 28 of 4013 (0.70%; 95% CI, 0.46%-1.01%) and 28 of 3413 (0.82%; 95% CI, 0.55%-1.18%) at each hospital. Forty-one percent of HCV-positive patients had any reported HCV risk factors. Hepatitis C virus-positive patients were less likely to have private insurance and more likely to have a history of cannabis, cocaine, and injection drug use (P < .001). The HCV rates were higher among antepartum admissions compared with delivery admissions and higher than that of hepatitis B virus (0.65%; 95% CI, 0.48-0.86), human immunodeficiency virus (0.27%; 95% CI, 0.16-0.42), and syphilis (0.16%; 95% CI, 0.08-0.28).
Conclusions: We found a higher than expected HCV seroprevalence among pregnant women and higher than most other STIs routinely screened for in pregnancy. Most patients had no risk factors. These findings support universal screening for hepatitis C during pregnancy.